UNASSIGNED：为了表征现有的心电图（ECG）-人工智能（AI）算法在免疫介导的坏死性肌病（IMNM）中左心室功能障碍（LVD）的实用性。
UNASSIGNED：在我们的三级护理神经肌肉诊所内对符合欧洲神经肌肉中心诊断标准（2000年1月1日至2020年12月31日）的IMNM患者进行了一项回顾性队列观察性研究。应用了使用12导联标准ECG检测LVD的经过验证的AI算法。输出表示为LVD的百分比概率。回顾了免疫治疗前后的心电图。将LVD预测的概率评分与超声心动图进行比较，免疫治疗反应，和死亡率。
UNASSIGNED：在具有可用超声心动图的IMNM患者中，74％（89个中的68个）的LVD预测中，ECG-AI算法具有可接受的准确性（区分阈值，0.74；95%CI，0.6-0.87）。这转化为检测LVD的80.0%的灵敏度和62.8%的特异性。最佳截止概率预测是LVD的7倍(赔率比，6.75；95%CI，2.11-21.51；P=.001）。早期发现发生在18％（89中的16例）最初的超声心动图正常且没有心肺症状的患者中。其中6人随后进展为LVD心肺功能衰竭。接受免疫治疗的患者的LVD概率评分有所改善(中位数斜率，-3.96；R=-0.12；P=.002）。LVD概率评分异常时，死亡率风险高7倍(风险比，7.33；95%CI，1.63-32.88；P=.009）。
未经批准：在IMNM中，AI-ECG算法帮助检测LVD，加强推进超声心动图测试的决策，同时也告知死亡风险，这在决定免疫治疗升级和监测方面很重要。
UNASSIGNED: To characterize the utility of an existing electrocardiogram (ECG)-artificial intelligence (AI) algorithm of left ventricular dysfunction (LVD) in immune-mediated necrotizing myopathy (IMNM).
UNASSIGNED: A retrospective cohort observational study was conducted within our tertiary-care neuromuscular clinic for patients with IMNM meeting European Neuromuscular Centre diagnostic criteria (January 1, 2000, to December 31, 2020). A validated AI algorithm using 12-lead standard ECGs to detect LVD was applied. The output was presented as a percent probability of LVD. Electrocardiograms before and while on immunotherapy were reviewed. The LVD-predicted probability scores were compared with echocardiograms, immunotherapy treatment response, and mortality.
UNASSIGNED: The ECG-AI algorithm had acceptable accuracy in LVD prediction in 74% (68 of 89) of patients with IMNM with available echocardiograms (discrimination threshold, 0.74; 95% CI, 0.6-0.87). This translates into a sensitivity of 80.0% and specificity of 62.8% to detect LVD. Best cutoff probability prediction was 7 times more likely to have LVD (odds ratio, 6.75; 95% CI, 2.11-21.51; P=.001). Early detection occurred in 18% (16 of 89) of patients who initially had normal echocardiograms and were without cardiorespiratory symptoms, of which 6 subsequently advanced to LVD cardiorespiratory failure. The LVD probability scores improved for patients on immunotherapy (median slope, -3.96; R = -0.12; P=.002). Mortality risk was 7 times greater with abnormal LVD probability scores (hazard ratio, 7.33; 95% CI, 1.63-32.88; P=.009).
UNASSIGNED: In IMNM, an AI-ECG algorithm assists detection of LVD, enhancing the decision to advance to echocardiogram testing, while also informing on mortality risk, which is important in the decision of immunotherapy escalation and monitoring.
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